Survey - Tour de Cure 2021 - OFFICIAL Jerseys

	Please complete the information below to inform us of your Tour de Cure jersey preferences.
*1.	Question - Required - BY RAISING $1,000+ YOU HAVE QUALIFIED FOR A 2021 TOUR DE CURE JERSEY. WOULD YOU LIKE TO RECEIVE IT?
	Even if you have elected to not receive your earned jersey, please help us confirm that our records are up-to-date and fill in the information below. Thank you!
*2.	Question - Required - Jersey size
*3.	Question - Required - First Name
*4.	Question - Required - Last Name
*5.	Question - Required - Email address
*6.	Question - Required - Phone number
	MAILING ADDRESS
*7.	Question - Required - Street address
*8.	Question - Required - City
*9.	Question - Required - Province
*10.	Question - Required - Postal code